• Title/Summary/Keyword: 완화의료

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Awareness and Attitude Change after End-of-Life Care Education for Medical Students (말기환자 돌봄 교육 후 의과대학생의 인식과 태도 변화)

  • Kim, Hyun-Kyung;Nam, Eun-Mi;Lee, Kyoung-Eun;Lee, Soon-Nam
    • Journal of Hospice and Palliative Care
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    • v.15 no.1
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    • pp.30-35
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    • 2012
  • Purposes: Most medical schools in Korea do not provide adequate education in end-of-life care. This study was designed to illustrate the need to improve end-of-life care education and to assess the effect of the education on fourth-year medical students' awareness and attitude towards hospice and palliative care for terminally ill patients. Methods: One hundred sixty six fourth-year medical students were surveyed with questionnaires on end-of-life care before and after they received the education. Results: Before receiving the education, students most frequently answered "at the end of life" (33.6%) was appropriate time to write an advance medical directive. After the education, the most frequent answer was "in healthy status" (58.7%). More students agreed to withholding or withdrawing futile life-sustaining treatment increased after the education (48.1% vs. 92.5% (P<0.001) for cardiopulmonary resuscitation, 38.3% vs. 92.5% (P<0.001) for intubation and mechanical ventilation, 39.1% vs. 85.8% (P<0.001) for inotropics, 60.9% vs. 94.8% (P<0.001) for dialysis and 27.8% vs. 56.0% (P<0.001) for total parenteral nutrition). Significantly more students opposed euthanasia after the education (46.6% vs. 82.1%, P<0.001). All students agreed to the need for education in end-of-life care. Conclusion: After reflecting on the meaning of death through the end-of-life care education, most students recognized the need for the education. The education brought remarkable changes in students' awareness and attitude towards patients at the end of life. We suggest end-of-life care education should be included in the regular curriculum of all medical schools in Korea.

The Adverse Effects of Radiotherapy and Its Management in the Hospice and Palliative Care Patients (호스피스.완화의료 환자에게 적용한 방사선 치료의 부작용과 대처법)

  • Lee, Soon-Sin;Park, Young-Jin;Han, Seong-Ho;Park, Joo-Sung
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.61-70
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    • 2011
  • Recent advances in techniques and strategies use to detect cancer in its early stages and to treat it effectively has the survival rate of cancer patients and the number of long-term cancer survivors continually increasing. Unfortunately, many cancer survivors are at risk for various late and long-term effects of cancer treatments including the radiotherapy. Long-term cancer survivors can be also seen for a hospice and palliative care because of cancer recurrence and they are at risk of delayed reactions to radiotherapy. So, the understanding and knowledge of radiation reactions is required for the proper medical diagnosis, management, and coordination of the potential reactions that may occur in these care setting. In effort to increase the survival rate in cancer patients and to decrease the adverse effects of cancer treatment, many clinical studies have been and continue to be conducted. The efforts of these studies have thus resulted in the advancement of cancer treatments. Regrettably, the overall interest in how to manage adverse effects of cancer treatment such as radiotherapy appears seemingly low in clinical practice and its advanced studies as a whole are delayed and deficient. It is imperative that the medical community show an enthusiastic interest in the aftercare of cancer patients and cancer survivors in order to create a complementary integrative approach that will eliminate radiotherapy related pain/discomfort or illness in hospice and palliative care settings.

The Impact of Palliative Care Practitioners' Workplace Spirituality on Caring for Terminally Ill People (완화의료 전문인들의 일터영성(workplace spirituality)이 말기환자 돌봄수행에 미치는 영향)

  • Hong, Young Joon;Lim, Seonghee
    • Korean Journal of Family Social Work
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    • no.57
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    • pp.69-98
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    • 2017
  • This study aims to examine the direct effects of two workplace spirituality dimensions, community at work and meaning in work, and burnout on three caring dimensions, emotional, social and spiritual care, for terminally ill people. It also seeks to examine the moderating effect of burnout in the relationship between two workplace spirituality dimensions and three caring dimensions. For these purposes, data were collected from 114 interdisciplinary team members, doctors, nurses, social workers and pastors, working in 68 palliative care in nationwide by questionnaires. The study results indicated that community at work has a positive effect on emotional care, and that meaning in work has a positive effect on social and spiritual care. The results also provided that burnout does not impact on three caring dimensions and has no moderating effect in the relationship between two workplace spirituality dimensions and three caring dimensions. In the findings, managers or leaders from palliative care should consider the potentially positive influence of workplace spirituality on caring for terminally ill people and can improve practitioners' performance with any interventions to increase workplace spirituality. The limitations of this study and recommendations for the future research were discussed.

The Effects of Hospice & Palliative Care Education Program on Spiritual Well-Being and Knowledge Regarding Advance Directives of Nursing Students (호스피스·완화의료 교육프로그램이 간호대학생의 영적안녕감 및 사전의료의향서 지식에 미치는 효과)

  • Kim, In Sook;Jang, Sun Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.1
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    • pp.732-738
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    • 2020
  • This study examined the effects of hospice & palliative care education programs for nursing students, in terms of spiritual well-being and knowledge concerning advance directives. This is a quasi-experimental study of non-equivalent control groups, and includes a pre-test and post-test design. Data was collected between September to December 2018, enrolling third grade nursing college students attending a university in C city: 22 subjects in the experimental group and 27 subjects in the control group. The experimental group was provided the education as a regular subject, 2 hours a week for 7 weeks, for a total of 14 hours. Ed. Notes: I suggest you maintain any one unit for mentioning time. Hence, I changed 120 mins to 2 hours. Data were analyzed by X2 test, Fisher's exact, t-test, independent t-test, and paired t-test, using the SPSS 21.0 program. After attending the program, spiritual well-being showed a significant increase (t=2.80, p=0.009). However, there was no significant difference between groups in knowledge regarding advance directives (t=1.33, p=0.190). Our results indicate that the hospice & palliative care education program helps nursing students improve their score of spiritual well-being. We believe that these results contribute basic data for the future development of hospice-palliative care curriculum.

호스피스 환자의 통증관리에 대한 평가

  • Lee, Chang-Geol;Lee, Won-Hui;Lee, Mi-Ra;Kim, Yeong-Jin;Lee, Gyeong-Ok;Kim, Ok-Gyeom;Kim, Yeong-Sun;Kim, In-Hye;Won, Yeong-Hui;Kim, Mi-Jeong;Nam, Jeong-Mo
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2003.07a
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    • pp.96-97
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    • 2003
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Cases and Literature Review of Timing for Withdrawal of Palliative Chemotherapy (진행성 암환자에서 완화적 항암치료 중단 시점의 결정에 대한 증례보고와 문헌고찰)

  • Jeong, Yun Jin;Kim, Do Yeun
    • Journal of Hospice and Palliative Care
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    • v.19 no.1
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    • pp.70-75
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    • 2016
  • Advanced incurable cancer patients receive palliative chemotherapy to prolong their life and improve quality of life. However, physicians should assess the timing to discontinue the treatment, especially near the final months of life, as palliative chemotherapy may accompany considerable toxicity. Even though there are no clear guidelines regarding the withdrawal timing for anticancer treatment in palliative setting, it is important clarify the issue for quality of care for advanced cancer patients. Here, we present two patients who received palliative chemotherapy for advanced colon cancer and non-small cell lung cancer, respectively. In both cases, it was jointly determined to stop palliative chemotherapy, and best efforts are made to relieve troublesome symptoms. The cases and up-to-date literature review will highlight the importance of the timing of discontinuation of cancer treatments when changes are being made to the health care system and hospice and palliative medicine is taking root in Korea.

An Architectural Planning Study on the Spatial Composition of Hospices Based on Typology (호스피스 시설의 유형별 공간구성에 관한 건축 계획적 연구)

  • Cho, Kwang-Hyun;Park, Jae-Seung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.8 no.1
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    • pp.45-52
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    • 2002
  • Recently cancer, AIDS, chronic sickness have increased according to the elevation of socioeconomic level and fast change of lifestyle. The number of patients receiving terminal care increased fairly because the span of life is extended by development of medicinal technology. Also necessity of hospice and palliative care was risen according to the request of terminal patients that remove pain and keep calm life by interest about quality of life. However architectural plan and type specialization of facility which can correspond team's composition and supplied nursing program are not consisting. This study researches about care environment of hospice facility plan through investigation into terminal patient's special quality. The purpose of this study is to propose fundamental datas of hospice facility for architectural plan through comparative analysis of cases of domestic and outside facilities.

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A Study on the Unit Spaces of Hospice Unit within a General Hospital (종합병원 호스피스 병동부 단위공간에 관한 연구)

  • Ha, Young-Chang;Lee, Teuk-Gu
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.7 no.2
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    • pp.37-45
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    • 2001
  • The hospice movement evolved as an alternative to hospitals as places to die. Recently, the palliative care for dying and hospice has been developed rapidly and placed itself as one of the medical systems. But the studies on hospice program and establishment method in Korea are few or no in comparison with developed countries. Hospice unit within a general hospital is more efficient hospice type than other terminal care establishments, therefor it will be developed rapidly. With this in mind, this study puts elements of architectural planning on the hospice unit for the space requirements. Also, It is investigated the architectural conditions of hospice unit within a general hospital, analyzed the unit space and spatial composition in hospice unit. The purpose of this study is to propose the fundamental data and unit space for architectural plan and design.

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Panperitonitis with Advanced Gastric Cancer - Based on Seminar of Korean Family Medicine Palliative Medicine Research Group - (진행된 위암 환자에게 발생한 범복막염 치료의 완화의학적 접근 - 대한가정의학회 완화의학연구회 세미나를 기초로 하여 -)

  • Jung, Yun-Joo;Kim, Dae-Kyun;Choi, Youn-Seon;Korean Palliative Medicine Research Group, Korean Palliative Medicine Research Group;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.35-39
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    • 2006
  • A 77-year-old female presented panperitonitis due to advanced gastric ranter during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved.

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